In the last couple of days, there has been another rash of posts here and there on the issue of bipolar illness in children -- I posted about this on 2/20/2007. There is something deeply troubling about the push to attach serious psychiatric diagnoses to children. What I find interesting in what I have read so far is an absence of curiosity about why the upswing in prevalence of this problem and very little, except from critics, about the tendency to label anything other than perfect behavior as pathological. Have we really become Lake Wobegone, where all the children are above average -- and those who are not are on meds? Think about the memorable naughty children from children's lit -- would they now be slapped with a psychiatric diagnosis and medicated out of their naughtiness? *
Yesterday, Furious Season critiqued a piece by John McManamy in which he defends the practice of so-labeling kids. When I read this by McManamy:
"Then came the book that put the illness on the map. In Jan 2000, “The Bipolar Child” by Demitri Papolos MD and Janice Papolos hit the shelves and became a surprise best-seller. Almost instantly, parents started using the book to educate their child’s clinicians and educators...
Dr Papolos had the MD, but his wife Janice was the one who possessed perfect pitch in connecting to readers. To fully appreciate her contribution, one only has to sample the 100 reader reviews on Amazon, from which the following is representative:
"The first time I read this book after my 8-year-old son was finally diagnosed properly four years ago, I cried with relief that FINALLY what our family had been living with was right there in black and white … It brings peace to your chaos ... it helps give you control over this crazy situation. As we say in the Bipolar Parents support group, ‘RUN, don't walk - buy this book NOW!’"
I was surprised that there is so little critical attention paid to the fact that this may in significant part be driven by parental desire to have a label for their kids rather than by an actual disorder. This seems to have become commonplace in the last 15 years or so. And with it, skyrocketing numbers of kids labeled as ADHD, Oppositional Defiant Disorder and now Bipolar. The labels, attached at ever earlier ages, become self-fulfilling prophecy as problems become center stage and strengths are all but ignored. Where there used to be an attitude that most kids will outgrow the problems of childhood, if not on their own then with some guidance and discipline, today we seem to be eager to tag them as mentally ill, perhaps consigning them to a degree of perceived disability and illness for life. I find this deeply troubling.
I know that there are children with serious behavior problems. I also know that in many places and for many parents, medication rather than behavioral approaches are the first line approach rather than the last resort. I still think that in most of these cases, behavioral interventions, especially when made early, would succeed and leave both parents and children equipped with tools for dealing with problems in the future.
Could it be that as the pressure which parents feel to maximize their children's potential by enrolling them in sports, lessons of all kinds, concern about making it into the best schools and then colleges is far more about the parents' narcissism than it is about the needs and wants of the child? Twenty-five years ago, David Elkind sounded the alarm about stressing kids in his book, The Hurried Child -- what we are seeing today seems the outgrowth of what was already observable to Elkind in the early 80's, only now things are worse.
* Click here for a nice article reviewing the naughty children of children's literature.